7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 1/17
CASE REPORT
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 2/17
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 3/17
CASE REPORT
Seorang wanita (81 th) tidak merokokmasuk rumah sakit karena batuk danhemoptisis . e!a"a mu"ai satu minggu .
Sebuah nodu"ar bera#un pada gondokte"ah didiagnosis 1$ tahun sebe"um danmendapat PT% &$$ mg setiap hari ' se!aksaat itu . sebe"umna meno"akpengobatan odium radioakti
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 4/17
%!i "aboratorium menun!ukkan adana *
1. anemia normositik normokromik anemiahemog"obin 8'1 g + d, (11.- 1-'- + d") '
&. se" darah putih dan p"ate"et norma" '/. peningkatan C reakti protein 1'0 mg + d, ( $'-
mg + d, ) dan tingkat sedimentasi eritrosit /$mm + !am ( &$ mm + !am ) .
2. 3ungsi tiroid ' ungsi hati dan koagu"asi tesnorma" .
-. nitrogen urea darah 1&$ mg + d, (14 2/ 5g +d, )
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 5/17
1. kreatinin &'-4 mg + d, ($'-1$'6- mg +d, ) .
&. hematuria dan proteinuria
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 6/17
Pemeriksaan biopsi gin!a"
7iopsi gin!a" menun!ukkanadana SVV (Small vesselvasculitis) dengan nekrosis
fbrinoid denganinamatory infltrasi selmononuklear ' se"u"er#res#ent ' pe#ahna kapsu"
7owmans ' segmenta"oka" g"omeru"osk"erosis 'brosis interstitia" kortika"dan atro tubu"ar.
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 7/17
9AS:,
;:A<OSA*
PT%indu#ed pA<CApositi=e S>> withpu"monar and rena" in=o"=emen.
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 8/17
PE57A9ASA<
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 9/17
(g"omeru"oneritis) ada"ah gangguangin!a" gin!a" ang mempengaruhi sup"aidarah dari tubu"us gin!a". 9a" ini
mengakibatkan hi"angna unit ungsiona"ang "engkap ang disebut neron. 9a"ini menebabkan ketidakmampuan gin!a"untuk membersihkan produk dari
metabo"isme protein' angmenebabkan peningkatan kadar ureanitrogen darah (7%<) dan kondisi ang
dikena" sebagai sindrom uremik.
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 10/17
(g"omeru"oneritis) terbagi men!adi / *
1. "omeru"oneritis Akut
&. "omeru"oneritis Progresi=itas #epat(<PC)
/. "omeru"oneritis ?ronis
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 11/17
"omeru"oneritis progresi #epat ada"ahperadangan g"omeru"us ang ter!adisedemikian #epat sehingga ter!adi
penurunan 3R -$@ da"am / bu"ansete"ah awitan penakit."omeru"oneritis progresi #epat dapatter!adi akibat perburukan
"omeru"oneritis akut' suatu penyakitotoimun' atau sebabna idiopatik( tidak diketahui ).
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 12/17
Pemeriksan penun!ang
cytoplasmic antineutrophil cytoplasmicantibodies (#A<CA)
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 13/17
Prop"thioura#i" ( PT% ) ada"ah sa"ah satuObat ang pa"ing sering digunakan
da"am pengobatan hipertiroidisme .barubaru ini te"ah di"aporkan bahwaPT% dapat meningkatkan antibodisitop"asmik antineutrophi"i# ( A<CA )=asku"itis positi dan g"omeru"oneritisdapat ter!adi terkait pengobatan denganPT%.
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 14/17
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 15/17
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 16/17
7/23/2019 Ptu Induce Renal Diseaseff
http://slidepdf.com/reader/full/ptu-induce-renal-diseaseff 17/17
?ES:5P%,A<
Penggunaan PT% pada pasien dengangangguan gangguan tiroid hendak"ahmempertimbangkan penggunaan da"am
!angka waktu ang "ama' e=a"uasipemeriksaan "ab untuk cytoplasmicantineutrophil cytoplasmic antibodies (#A<CA) uga se"a"u dipantau.